The value of a second transurethral resection for T1 bladder cancer
Article first published online: 23 MAR 2006
Volume 97, Issue 6, pages 1199–1201, June 2006
How to Cite
SCHWAIBOLD, H. E., SIVALINGAM, S., MAY, F. and HARTUNG, R. (2006), The value of a second transurethral resection for T1 bladder cancer. BJU International, 97: 1199–1201. doi: 10.1111/j.1464-410X.2006.06144.x
- Issue published online: 9 MAY 2006
- Article first published online: 23 MAR 2006
- Accepted for publication 11 January 2006
- superficial bladder cancer;
- second transurethral resection;
- residual cancer
To evaluate a series of repeat transurethral resections (TURs) of tumour in patients with T1 bladder cancer, usually used to ensure a complete resection and to exclude the possibility muscle-invasive disease.
PATIENTS AND METHODS
In all, 136 consecutive patients had a second TUR because of a histopathological diagnosis of T1 transitional cell carcinoma (TCC) after their initial TUR. Of the 136 patients, 101 were first presentations and 35 had recurrent tumours. The second TUR was done 4–6 weeks later. The evaluation included the presence of previously undetected residual tumour, changes to histopathological staging/grading, and tumour location.
In all, 71 patients (52%) had residual disease according to findings from specimens obtained during the second TUR. The staging was: no tumour, 65 (48%); Ta, 11 (8%); T1, 32 (24%); Tis, 15 (11%); and ≥ T2, 13 (10%). Histopathological changes that worsened the prognosis (>T1 and or concomitant Tis) were found in 21% of patients. Residual malignant tissue was found in the same location as the first TUR in 86% of the patients, and at different locations in 14%. Overall, 28 patients (21% of the original 136) had a radical cystectomy as a consequence of the second TUR findings.
A routine second TUR should be advised in patients with T1 TCC of the bladder, to achieve a more complete tumour resection and to identify patients who should have a prompt cystectomy.